Individual provider Active NPI

Darla Mae Kieser

  • Speech-Language Pathologist
  • Belvidere, IL
National Provider Identifier
1134633415
Registry record updated Jan 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146.002304 Issued in IL
Practice address
1031 5TH Ave
Belvidere, IL 61008-5139
Phone
(815) 262-1559
NPI assigned
Nov 26, 2017
Last updated
Jan 1, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 1, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146.002304 IL Primary

Addresses

Primary practice location

1031 5TH Ave
Belvidere, IL 61008-5139

Mailing address

8693 Centaur Dr
Belvidere, IL 61008-8721
Phone (815) 262-1559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
146.002304ILMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1511654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514764800000",
    "number": "1134633415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8693 CENTAUR DR",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610088721",
            "telephone_number": "815-262-1559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 5TH AVE",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610085139",
            "telephone_number": "815-262-1559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIESER",
        "first_name": "DARLA",
        "middle_name": "MAE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-26",
        "last_updated": "2018-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.002304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belvidere, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.